Group Health Services

WellRithms is helping protect the financial health of your plan and members.

There are BILLIONS of reasons to fight healthcare overbilling

Million-dollar claims are more and more frequent.  Outpatient procedures commonly exceed $50,000. Inpatient procedures frequently exceed $100,000.  Payors and administrators lack supporting documentation to really understand the bill.

WellRithms integrates with the claims administration process to ensure that every bill is cleaned of errors, accurately priced, and consistent with the care received.

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A Year

That’s the average cost of family health benefits coverage, including employee contribution.

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Innovative Solutions

Experience Guaranteed Savings

WellRithms Is the Solution for Accurate Medical Claim Review and Repricing

In Network Impact

Classification, Edits, & Review™

  • Network claims are reviewed line-by-line using WellRithms’ Classification, Edits, & Review (CER) system, before PPO discount is applied.

Inpatient Itemized Bill Review

  • Automated Line-by-Line review.  Amplifying the review process by automating data extraction from imaged itemized bills and mapping them into our system.
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Out-of-Network Impact

Sustainable Claims Pricing™ (SCP)

  • Revolutionizing the way out-of-network and catastrophic healthcare bills are adjudicated.

Air / Ground Ambulance Repricing

  • Ensures the accuracy and integrity of medical bills before payment.
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Network Replacement Impact

Next-Generation Pricing

  • WellRithms transforms healthcare billing with secure, innovative pricing and unmatched protection for members and plans.

RBP Cleanup

  • Ensuring disputes are resolved with accuracy and fairness, backed by full legal and financial support.
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Shield Indemnification™

Guaranteeing our recommended payment amount

Shield Indemnification™ protects carriers, plans, and members from the adverse impact of litigation expenses and balance billing tactics.

We are backed by a captive insurance company that allows for the transfer of all legal and financial liability from the payor to WellRithms, thereby guaranteeing the recommended payment amount.

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